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Income Taxes Rate Reconciliation (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Statutory Federal Income Tax Rate 21.00% 21.00% 21.00%
Provision for Income Taxes at Statutory Rate $ 1,517 $ 855 $ 685
Foreign rate differential (223) (204) (375)
Income tax credits (335) (213) (211)
Global intangible low-taxed income 86 92 29
Foreign-derived intangible income (156) (111) (47)
Excess tax benefits from stock options and restricted stock units (114) (80) (77)
Provision for (reversal of) tax reserves, net (26) 62 (49)
Intra-entity transfers   (79)  
Foreign exchange loss on inter-company debt refinancing (47) (62)  
Domestication transaction (263)    
Valuation allowance 379 (4) 260
Transition tax and other impacts of U.S. tax reform   8 117
Withholding taxes 115 38 31
Basis difference on disposal of business   73  
Tax return reassessments and settlements (196) (6) (26)
State income taxes, net of federal tax 147 22 21
Other, net (34) (17) (34)
Provision for Income Taxes 850 374 324
Tax Cuts and Jobs Act, Income Tax Expense (Benefit)   1 68
US foreign tax credits generated by repatriation of foreign earnings 96 75  
Deferred Tax Asset, Interest Carryforward [Member]      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Valuation allowance 212    
United States      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Provision for (reversal of) tax reserves, net (378) (7)  
Valuation allowance 156    
Tax return reassessments and settlements (25)    
Unrecognized tax benefits reclassed to accrued income taxes in connection with IRS settlement 144    
Charge for Expired Tax Credits due to Audit Settlement $ 53    
Disposal Group, Held-for-sale, Not Discontinued Operations [Member] | Anatomical Pathology business [Member]      
Effective Income Tax Rate Reconciliation, Amount [Abstract]      
Valuation allowance     $ 71
Income Tax Provision Related to Gain of Sale of Business   $ 191